Epidemiological and virological analysis of couples infected with hepatitis C virus

Background-If transmission of hepatitis C virus (HCV) infection through par enteral exposure is well documented, sexual transmission of HCV is still de bated. Aims-To perform extensive epidemiological and virological analysis in 24 co uples in which each spouse was anti-HCV positive in order to delineate more precisely potential sexual transmission of HCV. Patients-Twenty; four couples in which each partner was anti-HCV positive. These 48 spouses were recruited in a liver unit by regular screening of spo uses of index patients. Methods-All 48 spouses completed an epidemiological questionnaire on risk f actors for HCV. Qualitative detection of serum HCV RNA and determination of HCV type by genotyping and serotyping were performed. Sequence analysis of HCV strains by phylo,phylogenetic analysis was carried out in seven couple s with concordant genotypes. Results-The mean (SD) partnership duration was 12 (10) years. Serum HCV RNA was detected in both partners in 18 of the couples (75%) and in only one p artner in six of the couples (25%). HCV typing showed concordant genotypes in 12 couples (50%), discordant genotypes in seven (29%), and in the other five couples (21%) only one spouse could be genotyped. Of the 48 spouses, 3 3 had a major risk factor for HCV transmission such as transfusion (n = 6) and intravenous drug use (n = 27). Eleven of the 12 couples infected with t he same HCV genotype had at least one parenteral risk factor for viral tran smission in both spouses. Whatever the genotype concordance, in most couple s (75%), both spouses showed parenteral risk factors for viral transmission . Sequence analysis of HCV strains was possible in seven of 12 couples with identical genotype and showed different and identical isolates in four and three couples respectively. Conclusion-The study emphasises the risk of overestimating the importance o f a very low sexual HCV transmission risk as against other, mainly parenter al, risk factors.